Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
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Gutmann, A; Kaier, K; Sorg, S; von Zur Mühlen, C; Siepe, M; Moser, M; Geibel, A; Zirlik, A; Ahrens, I; Baumbach, H; Beyersdorf, F; Vach, W; Zehender, M; Bode, C; Reinöhl, J.
Analysis of the additional costs of clinical complications in patients undergoing transcatheter aortic valve replacement in the German Health Care System.
INT J CARDIOL. 2015; 179(4): 231-237.
Doi: 10.1016/j.ijcard.2014.11.095
Web of Science
PubMed
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- Co-Autor*innen der Med Uni Graz
- Zirlik Andreas
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- Abstract:
- This study aims at analyzing complication-induced additional costs of patients undergoing transcatheter aortic valve replacement (TAVR). In a prospective observational study, a total of 163 consecutive patients received either transfemoral (TF-, n=97) or transapical (TA-) TAVR (n=66) between February 2009 and December 2012. Clinical endpoints were categorized according to VARC-2 definitions and in-hospital costs were determined from the hospital perspective. Finally, the additional costs of complications were estimated using multiple linear regression models. TF-TAVR patients experienced significantly more minor access site bleeding, major non-access site bleeding, minor vascular complications, stage 2 acute kidney injury (AKI) and permanent pacemaker implantation. Total in-hospital costs did not differ between groups and were on average €40,348 (SD 15,851) per patient. The average incremental cost component of a single complication was €3438 (p<0.01) and the estimated cost of a TF-TAVR without complications was €34,351. The complications associated with the highest additional costs were life-threatening non-access site bleeding (€47,494; p<0.05), stage 3 AKI (€20,468; p<0.01), implantation of a second valve (€16,767; p<0.01) and other severe cardiac dysrhythmia (€10,611 p<0.05). Overall, the presence of complication-related in-hospital mortality increased costs. Bleeding complications, severe kidney failure, and implantation of a second valve were the most important cost drivers in our TAVR patients. Strategies and advances in device design aimed at reducing these complications have the potential to generate significant in-hospital cost reductions for the German Health Care System. Copyright © 2014. Published by Elsevier Ireland Ltd.
- Find related publications in this database (using NLM MeSH Indexing)
- Aged -
- Aged, 80 and over -
- Delivery of Health Care - economics
- Delivery of Health Care - trends
- Female -
- Female - epidemiology
- Hospital Costs - trends
- Humans -
- Male -
- Postoperative Complications - diagnosis
- Postoperative Complications - economics
- Postoperative Complications - epidemiology
- Prospective Studies -
- Registries -
- Transcatheter Aortic Valve Replacement - economics
- Transcatheter Aortic Valve Replacement - trends
- Treatment Outcome -
- Find related publications in this database (Keywords)
- TAVI
- TAVR
- Resource utilization
- Cost analysis
- VARC complication